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Free Compliance Resources

Practical tools, checklists, and practitioner guides for Medicare Advantage compliance teams. Free to use, no email required.

Tools and Checklists

Interactive Tool

CMS Universe Header Check

Validate your ODAG, CDAG, FA, SNPCC, and CPE universe file headers against the current CMS Program Audit spec. Runs entirely in your browser, so your headers never leave your machine.

Universe FilesProgram AuditIDS Prevention
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Printable Checklist

CMS Compliance Checklist

A practical checklist covering core CMS requirements for Medicare Advantage organizations, from universe data readiness to compliance program documentation. Print it or work through it on screen.

CMS RequirementsAudit PreparationDocumentation
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Reference

Compliance Glossary

Plain-English definitions for the terms MA compliance teams live with: IDS, CAR, universes, COA, effectuations, and more, each linked to a deeper guide.

TerminologyAudit ProtocolsQuick Reference
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Practitioner Guides

In-depth guides to the 2026 CMS Program Audit framework and every universe protocol, written by people who validate these files for a living.

Start here

The CMS Program Audit: A Complete Guide

The 2026 framework, the audit lifecycle, and all five protocols in one place, with links into every deep-dive below.

Compliance8 min read

What Is a CMS Universe Scrubber?

Universe is CMS's word, not a vendor's. What universe scrubbing software actually validates (structure, formats, timeliness logic, cross-table consistency), why IDS makes it matter, and seven questions for evaluating any tool in the category.

Audit Prep15 min read

When the Engagement Letter Lands: A 30-Day Playbook for the 2026 CMS Audit Cycle

A former Medicare Advantage Chief Compliance Officer's 30-day playbook for the first month after a 2026 CMS program audit engagement letter arrives. Days 1-3, 4-10, 11-20, 21-30, plus cross-cutting readiness items.

Compliance8 min read

Big Changes Coming to CMS Program Audits in 2026

CMS released their 2026 Program Audit Updates memo with significant changes: scoring eliminated, ICAR/ORCA classifications removed, new CPE evaluation approach, and evolved validation audit requirements. Here's what compliance teams need to know.

Compliance10 min read

Invalid Data Submission (IDS) in 2026: What You Need to Know

With CMS eliminating audit scoring and ICAR/ORCA classifications, Invalid Data Submission (IDS) becomes even more critical. Learn what triggers IDS findings and how to prevent them before February 2026.

Compliance14 min read

The ODAG Universe: A Table-by-Table Guide for Compliance Teams

A practical walkthrough of all 5 ODAG universe tables: OD, Reconsiderations, Payment, Effectuations, and Grievances. Learn what each table captures, which fields matter most, and where plans commonly get tripped up.

Compliance14 min read

The CDAG Universe: A Table-by-Table Guide for Part D Compliance Teams

A practical walkthrough of the Part D Coverage Determinations, Appeals and Grievances universe. Where it differs from ODAG, the timeliness rules that catch plans off guard, and the data quality issues we see most.

Compliance12 min read

The FA Universe: How CMS Audits Your Formulary at the Pharmacy Counter

The Formulary Administration audit looks at what your PBM rejected, what got transitioned, and whether members were notified on time. A practical walkthrough of where most plans get tripped up.

Compliance12 min read

CMS SNPCC Compliance Guide: Protecting Vulnerable Medicare Members Through Care Coordination

Learn how CMS SNPCC audits ensure Special Needs Plans deliver coordinated care. Understand the 13 CMS standards, HRA timeliness requirements, and how to build a proactive compliance program.

Compliance8 min read

The CPE COA Universe: Your Roadmap for CMS's New "Collaborating on Compliance" Approach

Under CMS's 2026 "Collaborating on Compliance" model, your COA universe becomes the foundation for every discussion with auditors. Learn what the 12 COA data elements mean, common gaps that undermine discussions, and how to prepare before February 2026.

Audit10 min read

CMS Audit Preparation for Medicare Advantage Plans: A 2026 Guide

How to prepare for a 2026 CMS Program Audit under the new CAR/Observation/IDS framework. Universe file validation, COA universe readiness, documentation requirements, and during-audit response.

Want the Automated Version?

These resources cover the manual work. The Sevana platform automates it: universe validation, guidance tracking, risk assessment, and audit-ready evidence in one place.